Unless otherwise stated in your policy or your Policy Schedule, this insurance does not cover claims related to or in any way caused or contributed to by:

• Planned treatment(s) which are defined as medical procedure(s) that in the 12 month period prior to an insured person first becoming insured under this policy or at the date that you increased their level of cover: a) an insured person had a date scheduled for such medical procedure(s) to be carried out; or b) an insured person was on a NHS waiting list for the medical procedure; or c) an insured person had been aware of or had been told by their GP or medical specialist that reasonable medical opinion would consider that a medical procedure may be required.
• An insured person’s failure to seek or follow medical advice where such failure is unreasonable in the opinion of a medical specialist appointed by us.
• Suicide, attempted suicide or intentional self- inflicted injuries.
• An insured person’s own criminal act.
• An insured person being under the influence of alcohol or drugs.
• • war or acts of terrorism
  • An insured person engaging in active war
  • nuclear risks
• Any medical procedure directly or indirectly arising from or as a consequence of professional sports where a fee is received for training or playing.
• Any medical procedure which is not listed in the SCHEDULE OF MEDICAL PROCEDURES AND BENEFITS in your Policy Document.

This insurance does not cover claims for, or in any way caused or contributed to by:

• Any dental condition or dentistry, including gum diseases and wisdom tooth extraction.
• Recurrent cancer.
• Treatment for a specific cancer which exceeds a maximum of one episode of surgery, one course of chemotherapy and one course of radiotherapy. No further treatments will be covered during an insured person’s lifetime either for additional treatment of the original cancer or for a recurrence of that cancer in the same place or another place in the body or for the occurrence of another cancer anywhere else in the body.
• Biopsies or endoscopic biopsies unless performed as a part of a listed surgical procedure such as arthroscopy, craniotomy, laparoscopy, nephroscopy or thoracostomy.
• Drainage of fluids or other substances through a tube or needle unless performed as a part of a listed surgical procedure such as arthroscopy, craniotomy, laparoscopy, nephroscopy or thoracostomy.
• Vasectomy or reversal of vasectomy.
• Female sterilisation, reversal of sterilisation or IVF treatment.
• Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Syndrome (HIV) or AIDS-related complex (ARC), howsoever this syndrome has been acquired or may be named.
• Any sexually transmitted disease.
• Cosmetic surgery other than for reconstruction after trauma or malignancy.
• Obesity surgery and associated cosmetic surgery including abdominoplasty.
• Obstetric surgery other than surgery for ectopic pregnancy, hydatidiform mole, selective feticide and surgery to treat a fetus in utero.
• Childbirth, whether natural or by Caesarean section.
• Gender reassignment or any related treatment whether or not it is for psychological purposes.
• Any medical condition resulting from a heart attack.

• All persons are employed by you. This can include any director of your company who is salaried by you.
• All persons have been declared by you to us via the administrator and are listed in the appendix of insured persons attaching to your Policy Schedule.
• All persons live in the United Kingdom, Channel Islands or Isle of Man for a minimum of 180 days a year.
• All persons are aged at least 18.

Heart Surgery is included in the Medical Recovery Insurance Schedule of Procedures.

Heart Attacks may not require surgery but will virtually always lead to time off work, these are also covered as a Band C benefit. Please see our definition of a Heart Attack in the Policy Document

Medical Recovery Insurance benefits are graded according to the recovery time of a procedure. Our plans do not distinguish as to where operations and medical procedures are carried out or how long they take.